What a difference a few decades make! When I was a growing girl in the city, our doctor lived a few streets away. He practiced from home, and would make a lot of house calls; needs must, because in those days just prior to WWII, there would be only one car to a household, if that, and the bread-winner would probably need it daily. A big, sick child could not be lumped in the mother’s arms to a doctor’s surgery streets away.

My big sister frequently suffered from ear abscesses, and this painful condition was always treated by the doctor himself as she sat up in her own bed. Lancing might be necessary. Peroxide drops that foamed the detritus out of her ear canal would be swabbed away until it ran clear. I do not recall any hand washing as he gave my mother instructions regarding the ear’s after-care, but we all felt better and relieved after his visit. An account would be sent by the end of the month, not one to ever break the bank and cause distress, usually a half guinea (10/6), which was five cents more than a dollar, a manageable amount when the father’s wage would be perhaps eight dollars weekly.

It was always possible to talk on the landline to our doctor if he were available. Willing to discuss the patient’s progress or otherwise, he would give free advice and allay fears prior to his next visit, or listen intently and suggest that he call the ambulance to take the sick person to hospital, which visit he would arrange himself, and make all the calls necessary. Unless requested, no other medical person, specialist or otherwise was involved. Our doctor was a very well-respected man, and no wonder. He took our tonsils out, set our fractures, removed our appendices and gall-bladders and delivered our babies.

So what do we do today? First, on phoning the medical practice, we must listen to a long, recorded diatribe about the rules pertaining to making an appointment, before being connected to a helpful receptionist who will sort out our needs and make the earliest appointment with the appropriate general practitioner. With luck, this could be in a few days’ time, but it might be several weeks before we can discuss our problem with our preferred doctor! And, of course, the visit is limited to fifteen minutes, after which an extra charge is levied. If one wishes to have a discussion per phone, one must make a tele-appointment, a paid consultation that is generally available within a few days. A rare, very costly home visit is mostly out of the question.

If the situation is dire, then one calls the ambulance. It is the Paramedic who decides what is to be done, where one is to be taken. After a long wait in Emergency, admission and ward allocation, one finally sees the specialist who is in charge of the case. Our general practitioner is not on the scene at all. The faces are all unfamiliar and we must hope for the best. It generally is, but discussion is not encouraged as time seems to be of the essence. Our next-of-kin is hard put getting information, and only with the patient’s permission.

While there are exceptions to every rule, it is obvious that conditions have changed radically. And, from the patient’s point of view, not for the better.